scholarly journals Application of failure mode and effects analysis (FMEA) to improve medication safety in the dispensing process – a study at a teaching hospital, Sri Lanka

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. A. L. Anjalee ◽  
V. Rutter ◽  
N. R. Samaranayake
Keyword(s):  
Sri Lanka ◽  
Failure Mode ◽  
Teaching Hospital ◽  
Failure Modes ◽  
Tertiary Care ◽  
Care Hospital ◽  
Patient Counseling ◽  
System Failures ◽  
Active Involvement ◽  
Risk Processes

Abstract Background Failure mode and effects analysis (FMEA) is a prospective, team based, structured process used to identify system failures of high risk processes before they occur. Medication dispensing is a risky process that should be analysed for its inherent risks using FMEA. The objective of this study was to identify possible failure modes, their effects, and causes in the dispensing process of a selected tertiary care hospital using FMEA. Methods Two independent teams (Team A and Team B) of pharmacists conducted the FMEA for two months in the Department of Pharmacy of a selected teaching hospital, Colombo, Sri Lanka. Each team had five meetings of two hours each, where the dispensing process and sub processes were mapped, and possible failure modes, their effects, and causes, were identified. A score for potential severity (S), frequency (F) and detectability (D) was assigned for each failure mode. Risk Priority Numbers (RPNs) were calculated (RPN=SxFxD), and identified failure modes were prioritised. Results Team A identified 48 failure modes while Team B identified 42. Among all 90 failure modes, 69 were common to both teams. Team A prioritised 36 failure modes, while Team B prioritised 30 failure modes for corrective action using the scores. Both teams identified overcrowded dispensing counters as a cause for 57 failure modes. Redesigning of dispensing tables, dispensing labels, the dispensing and medication re-packing processes, and establishing a patient counseling unit, were the major suggestions for correction. Conclusion FMEA was successfully used to identify and prioritise possible failure modes of the dispensing process through the active involvement of pharmacists.

scholarly journals Application of Failure Mode Effect Analysis (FMEA) to Improve Medication Safety in the Dispensing Process – A Study at A Teaching Hospital, Sri Lanka

2021 ◽  
Author(s):  
J.A.Lakshika Anjalee ◽  
Victoria Rutter ◽  
Nithushi Samaranayake
Keyword(s):  
Sri Lanka ◽  
Failure Mode ◽  
Teaching Hospital ◽  
Failure Modes ◽  
Tertiary Care ◽  
Care Hospital ◽  
Effect Analysis ◽  
Mode Effect ◽  
Risk Processes ◽  
Failure Mode Effect Analysis

Abstract Background: Failure Mode Effect Analysis (FMEA) is a prospective, team based, structured process used to identify system failures of high risk processes before they occur. Medication dispensing is a risky process that should be analysed for its inherent risks using FMEA. Objectives: The objective of this study was to identify possible failure modes, their effects and causes in the dispensing process of a selected tertiary care hospital using FMEA. Methods: Two independent teams (Team A and Team B) of pharmacists conducted the FMEA for two months in the Department of Pharmacy of a selected teaching hospital, Colombo, Sri Lanka. Each team had five meetings of two hours each, where the dispensing process and sub processes were mapped, and possible failure modes, their effects, and causes, were identified. A score for potential severity (S), frequency (F) and detectability (D) was assigned for each failure mode. Risk Priority Numbers (RPNs) were calculated (RPN=SxFxD) to prioritise identified failure modes. Results: Team A identified 48 failure modes while Team B identified 42. Among all 90 failure modes, 69 were common to both teams. Using the RPN, Team A prioritised one failure mode, while Team B prioritised three (having identical RPNs). Both teams identified overcrowded dispensing counters as a cause for 57 failure modes. Redesigning of, dispensing tables, dispensing labels, the dispensing and medication re-packing processes, and establishing a patient counseling unit were the major suggestions for correction.Conclusion: FMEA was successfully used to identify and prioritise possible failure modes of the dispensing process through active involvement of pharmacists.

Carbapenem-Resistant Enterobacteriaceae Rectal Screening during an Outbreak of New Delhi Metallo-β-Lactamase–Producing Klebsiella pneumoniae at an Acute Care Hospital

2014 ◽  
Vol 35 (4) ◽  
pp. 434-436 ◽  
Author(s):  
Larissa M. Pisney ◽  
M. A. Barron ◽  
E. Kassner ◽  
D. Havens ◽  
N. E. Madinger
Keyword(s):  
Klebsiella Pneumoniae ◽  
Acute Care ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Acute Care Hospital ◽  
University Teaching ◽  
New Delhi ◽  
Care Hospital ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

We describe the results of carbapenem-resistant Enterobacteriaceae (CRE) screening as part of an outbreak investigation of New Delhi metallo-β-lactamase–producing CRE at a tertiary care university teaching hospital. The manual method for CRE screening was useful for detecting patients with asymptomatic CRE carriage but was time-consuming and costly.

A STUDY OF WASTE MANAGEMENT OF SAIDU TEACHING HOSPITAL

1969 ◽  
Vol 2 (1) ◽  
pp. 105-110
Author(s):  
Bushra Iftikhar ◽  
Muhammad Jan ◽  
Khurshid Ahmad ◽  
Satea Arif
Keyword(s):  
Waste Management ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Water Channel ◽  
Liquid Waste ◽  
Care Hospital ◽  
Operation Theatre ◽  
Blood Banks ◽  
Outpatient Departments ◽  
Infectious Waste

Objectives: The study was designed to find out the type and quantity of different type of wastes generated inthe two wings of Saidu Group of teaching Hospitals. The study also aimed at finding that whether facilitiesare available in different units for the segregation, storage, disinfection of infectious waste at the onset andmethods of disposal of waste within and outside the hospital. Also, types of items reused and their methodsof sterilization and the fate of used syringes was found out.Study Design: ObservationalMethodology: The study focus was Saidu Teaching Hospital (STH), a tertiary care hospital providingservices to the people of Swat, Malakand, Dir, Kohistan and areas far up to Chitral. Situated 1.5 Km apartSTH consists of two administrative units,Saidu Wing and Central Wing.A qualitative analysis of various aspects of waste management was done by reviewing the availableauthentic record and discussion with the sanitary and administrative staff of the hospital. All the data wascollected according to, and filled in a pre-designed questionnaire.Results: It was found that Saidu Teaching Hospital generates more than 550 Kg of solid waste and 1295liters of liquid waste per day, which makes 1.2 Kg/bed/day. As a whole 80% of the waste generated wasordinary garbage, 12% was infectious, 4% was Pharmacological, 3% pathological and 0.8% consisted ofsharps.The provision of facilities for the segregation of waste at outpatient departments, Wards, Operation theatreand Laboratories/Blood Banks were 7.5%, 7%, 20% and 28.5% respectively and for storage of waste beforedisposal at outpatient departments, Wards, Operation theatre and Laboratories / Blood Banks were 22%,8%, 0% and 28.5% respectively.Disinfection of infectious waste at outpatient departments, wards, operation theatre and laboratories / bloodbanks was 10%, 12%, 0% and 17% respectively. Methods used were treatment with phenyl and burning inopen air.About the removal of waste from hospital premises, 78% mentioned sweepers, 17% said rig pickers while5% said that there is no one to take away the waste.54% admitted that they threw the syringes as such in thebins.The study found that 80% of the waste went to the municipal corporation land fills, the rest was either burntor thrown as such into the water channel passing through the hospital (12% & 8% respectively). 67% blamedthe administration, 25 % held the doctors responsible, 37% charged the nursing staff and 67% blamed thesweepers for the faulty management of hospital waste.Conclusion: It is thus concluded that Saidu Teaching Hospital generates huge amount of solid and liquidwaste, which is not properly disposed off currently, therefore it needs modern and scientific waste disposalsystems.Keywords: Waste Management, hospital waste management, waste disposal

scholarly journals Prevalence and the risk factors for the carriage of beta-haemolytic streptococci among women visiting a tertiary care hospital in South India

2021 ◽  
Vol 8 (4) ◽  
pp. 308-312
Author(s):  
Pendru Raghunath ◽  
LN Rao Sadanand
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Latex Agglutination ◽  
Research Centre ◽  
Care Hospital ◽  
Microbiological Techniques ◽  
History Of ◽  
Group B

Streptococci are gram positive cocci arranged in chains and are part of normal flora of humans and animals. The present study is carried out to determine the prevalence and risk factors for the carriage of beta-haemolytic streptococci (BHS) among women visiting Dr. VRK Women’s Teaching Hospital & Research Centre, Hyderabad. Vaginal swabs were collected from 250 patients attending outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Swabs were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Sensitive isolates were presumptively identified as GAS and resistant isolates were identified as non-group A BHS (NGABHS). Presumptively identified GAS & NGABHS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. BHS were isolated from 12.4% of samples. As many as 12 BHS isolates were identified as GAS and 19 were identified as NGABHS. Ten of nineteen were identified as group B (GBS), 4 (12.9%) were identified as group C (GCS) and 5 (16.12%) were identified as group G (GGS). Among six clinical groups, the prevalence of GAS is highest i.e. 7.5% in female patients visiting Gynaecology OPD with history of white discharge. Prevalence of NGABHS was more among post insertion (18%) IUCD group compared to pre insertion (8%) IUCD group. GBS were isolated from 7% of samples from IUCD group and 4% of samples from prostitutes.This study reports the prevalence of BHS among women visiting a tertiary care hospital in Hyderabad. This study also identified certain risk factors such as IUCD usage and working as a FSW are associated with the increased prevalence of NGABHS especially GBS.

scholarly journals Endoscopic evaluation of patients with dyspepsia in a tertiary care hospital in Sri Lanka

2016 ◽  
Vol 33 (4) ◽  
pp. 23
Author(s):  
R. T. Gamage ◽  
J. R. Wijesekera ◽  
A. L. A. M. C. Ambegoda ◽  
D. T. Wijesinghe ◽  
K. I. Panditharathne
Keyword(s):  
Sri Lanka ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Endoscopic Evaluation

scholarly journals Prevalence of Pulmonary Tuberculosis among the suspected patients visiting tertiary care hospital in Birgunj, Nepal

2013 ◽  
Vol 1 (1) ◽  
pp. 48-52
Author(s):  
S Shrestha ◽  
B Shakya ◽  
P Shrestha
Keyword(s):  
Pulmonary Tuberculosis ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
National Medical College ◽  
Medical College ◽  
National Medical

Background and Objectives: Mycobacterial disease continues to cause high morbidity and mortality and is a major public health problem in Nepal. Bacteriological examination of sputum is the cornerstone in the diagnosis of pulmonary tuberculosis in the developing world. This prospective study was carried out with an objective to evaluate the prevalence of pulmonary tuberculosis among the patients visiting National Medical College Teaching Hospital by Ziehl- Neelsen (Zn) staining microscopy. Material and Methods: The study was cross-sectional study. Three consecutive early morning sputum collected from 626 patients were subjected to Zn staining and observed under oil immersion. Results: Among 626 patients, 85 (13.57%) were found to be Acid fast positive by Zn staining microscopy. Of total suspected patients,16.0% of male and 8.7% of female were infected, common among 41-60 years group (17.2%) followed by 21-40 years (12.6%) and multibacillary cases was 71.8%. Conclusion: The prevalence of pulmonary tuberculosis among National medical college teaching hospital was found to be higher than the Nation pulmonary tuberculosis detection rate, most commonly infecting males. DOI: http://dx.doi.org/10.3126/jmcjms.v1i1.7886 Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (1):48-52

scholarly journals Prevalence and associations of psychoactive substance use among male supportive staff members in a tertiary care hospital of Sri Lanka

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S293-S293
Author(s):  
Chathurie Suraweera ◽  
Iresha Perera ◽  
Priyanka Rupasinghe ◽  
Janith Galhenage
Keyword(s):  
Substance Use ◽  
Sri Lanka ◽  
Alcohol Use ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Psychoactive Substance ◽  
Staff Members ◽  
History Of ◽  
Psychoactive Substance Use

AimsThe study describes the prevalence and associated socio-demographic variables of psychoactive substance use among male supportive staff members at a tertiary care hospital in Sri Lanka.MethodA cross-sectional descriptive study was carried out among male supportive staff members of a tertiary care hospital in Colombo District, Sri Lanka by using a self-administered anonymous questionnaire. Participants were recruited using stratified cluster sampling in thirteen overseer divisions of the hospital. Anonymous questionnaires were collected into a sealed box and analysed using Statistical Package for Social Sciences 20.ResultThe mean age of the 404 male staff members who participated in the study was 38.78(SD = 10.90) years and 71.5% were married. Among them 202 (49.1%) were educated up to grade 6-11 and 30 of them has had encounters with law in the past. Thirty of participants had history of psychoactive substance use in the family. Alcohol was used more than once a month by 127(30.9%) and more than once a week by 19(4.6%) individuals. Among other substances, tobacco, beetle and beedi were used by 104(25.3%), 78(19.0%) and 18(4.4%) respectively at least once a month. Further, 22(5.3%), 20(4.8%), 7(1.7%) and 7(1.7%) participants used Mava, Cannabis, Methamphetamine and Thool respectively at least less than once a month. Heroin, Tramadol and Morphine were used by two individuals at least less than once a month. Among substance using participants, 132 wished to cut down their habit. Most commonly identified (14.1%) adverse consequence was financial issues secondary to psychoactive substance use. Eleven (4.5%) staff members used the substance at hospital. Alcohol use was associated with age more than 35 years (p = 0.039) and history of forensic involvement (p = 0.038). Tobacco(p = 0.000), beetle (p = 0.056), Cannabis (p = 0.000) and mava (p = 0.015) use were significantly associated with positive forensic history. Supportive staff members’ alcohol and cannabis use was associated with tobacco (p = 0.000, p = 0.000) and beetle use (p = 0.001, p = 0.049). Mava use was associated with alcohol (p = 0.060) use in addition to tobacco (p = 0.020) and beetle use (p = 0.008).Binomial logistic regression revealed alcohol use and beetle use were associated with the number of children in family and above associations.ConclusionCommonest psychoactive substance consumed by supportive staff members were alcohol, tobacco, beetle, Cannabis and Mava in descending order of frequency. Forensic history was significantly associated with substance use. True prevalence of substance use can be higher than these values.

INFLUENCE OF PHARMACEUTICALINFLUENCE OF PHARMACEUTICAL CARE ACTIVITIES ON KNOWLEDGE ATTITUDE AND PRACTICE (KAP) AMONG DIABETIC PATIENTS IN A TERTI CARE ACTIVITIES ON KNOWLEDGE ATTITUDE AND PRACTICE (KAP) AMONG DIABETIC PATIENTS IN A TERTIARY CARE HOSPITAL

2020 ◽  
pp. 36-40
Author(s):  
K. SHAILAJA ◽  
ANJU ABRAHAM ◽  
BINDHU BHARGAVI ◽  
R. DEVIKA
Keyword(s):  
Pharmaceutical Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Patient Counseling ◽  
Attitude And Practice ◽  
Baseline Values ◽  
Knowledge Attitude And Practice

Objective: To assess the influence of pharmaceutical care activities on Knowledge, Attitude and Practice (KAP) among type 2 diabetic patients. Methods: A total of about 301 patients with type 2 Diabetes Mellitus were recruited from a tertiary care hospital. Patients were educated about their disease condition, lifestyle modifications and diet regimen to be followed and were given instructions for improving medication adherence. In the initial session, no pharmaceutical care was given, in the second session patient counseling was given verbally and in the last session patient counseling was given both verbally and non-verbally by means of pamphlet distribution. KAP questionnaire and glycemic levels (glycated hemoglobin, fasting blood sugar and post-prandial blood sugar) of participants were obtained at baseline and at follow up. Results: The baseline values of FBS in patients before intervention was found to be 176.5±74.46 mg/dL and it was reduced to 140.7±43.9 mg/dL after 3 mo. Henceforth, there was also an improvement in the PPBS values which was found to be 254±77.3 mg/dL at the baseline and was 212.9±54.2 mg/dL after intervention. The baseline values of HbA1c is 8.144±1.727% and after intervention, value reduced to about 7.173±2.768%. After the intervention, it was found to be that 30%, 16% and 12% reduction in FBS, PPBS and HbA1c values and the P-value (<0.0001) found to be statistically significant. KAP scores also found to be improved after the intervention and statistically significant. The results clearly indicate that through proper guidance and educating the patients by the pharmacist is beneficial in managing the glycemic levels and reduce further complications. Conclusion: The study concluded that the pharmaceutical care by the pharmacist is highly essentially and useful for the patients to manage the glycemic index and prevent further diabetic complications.

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